Time-Limited Existential Therapy. Alison Strasser

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СКАЧАТЬ potentially a shift towards something new and exciting. And so I chose to ask for help. Jo Silbert has been a friend and fellow therapist for many years. Through her love of language, she shifted into writing and editing articles and books on psychotherapy. With her help, this second edition began to take shape.

      My first decision was to consolidate the two Wheels of Existence into one wheel. This new wheel combines the ideas from the original wheels and simultaneously allows for the integration of the philosophical ideas and the essential processes involved in existential practice. Broadly, the Wheel in this edition brings together the concept that our practice is phenomenological while maintaining the existential philosophy as the backdrop that informs our listening, questions, and reflections.

      In this second edition, I will expand on the concept of time‐aware therapy to reveal that all therapy can be viewed as time limited and discuss the various possibilities of using a time‐aware approach in practice to reveal how time can be used as an effective stratagem to enhance and highlight some of the existential human concerns. So, while the modular approach still remains valid, its ideas are transferable to all therapies.

      Therapy as time limited fits snugly into an existential perspective in that, in its very essence, therapy mirrors life in all its openings and closures, beginnings and endings, with its final culmination in death. These beginnings and endings of life range from the small and everyday – our waking up in the morning and going to sleep at night, starting and finishing a new project, beginning a new friendship and saying goodbye to others – to the more significant beginning of our birth and ending of our death. We are all being carried forward towards death, a being‐unto‐death as described by Heidegger (1962). The manner of our approach to how we tackle or manage these beginnings, endings, openings and closures in therapy can mimic how we negotiate life. Hence, the significance of time is tangible in every session.

      Time is also implicit in therapy, though usually unspoken, unless either the client or therapist is taking a break, or the end of therapy is nigh. There are numerous theories and approaches to addressing and grasping the meaning of breaks; yet working explicitly with temporality as an existential given gives a richness to time in all its complexity for both the therapist and client to work with.

I tend to work with clients with no fixed end to their therapy, or what is usually defined as open‐ended. This is partly due to my original training and also my own preference for working with clients over a longer period. The relationship that is at the crux of existential therapy ebbs and flow over a longer period and builds on an in‐depthness that doesn’t always have time to develop within the brief therapy scenario. I build in an ending process so that when it is time for the client to finish, we negotiate a series of sessions before the final closure. This manner of ending brings out many of the advantages of the time‐limited modular approach and the benefits for some clients of working over a longer time period. Later, I discovered that this was similar to Otto Rank’s (1929) concept of time‐limited therapy that I shall return to in Chapter 3. As so cogently described by a supervisee who closed her practice using this ‘time‐aware and time‐limited’ approach, ‘working with the ending was like a dream come true; my clients took up their own baton and truly worked in earnest’.

      Yalom (2008) writes about explicitly alluding to death in every session; I propose that our relationship to time is an expansive way of calling attention to endings that might include our relationship to our physical death but is inclusive of all the other beginnings and endings that occur in life. Every session has a start and finish, every day has its morning and night, every job has an induction and termination, and all relationships begin and end. By calling attention to this reality, it allows for the possibility of working with all the intrinsic anxieties, paradoxes, and vulnerabilities highlighted in the modular approach explored in the first edition.

      The proposal to bring time‐limited awareness to all therapy is about recognising that contextual working situations are diverse, that our circumstances differ, and that, as therapists, we have personal preferences. My work as a supervisor has privileged me with insights into the gamut of the many and varied circumstances, contexts and experiences of my supervisees: therapists and supervisors in private practice; practitioners that work in agencies with a fixed number of client sessions varying from 6 weeks to 6 months; those that permit additional sessions; those that require clients to be referred elsewhere after the maximum sessions are complete. These insights have highlighted how we all need to find our own path, our own voice as therapists. Working with the idea of time and its limitations has its own flexibility and can be used and worked with as seen fit and appropriate by each individual.

In some obvious, some subtle ways, this second edition was in its conception – both during and as soon as the first edition was put to bed – reflecting the notion that speaks directly to one of the existential ideas that time is in constant flow with no beginning or ending. This might appear to be in direct opposition to time‐limited therapy which honours the idea that time is limited, thus highlighting another existential ‘given’ that life is peppered with paradoxes. This second edition is an opportunity to extend the original ideas around time in therapy to include a broader spectrum of practitioners and clients. There are many advantages to shorter‐term therapy and there are other benefits to working in a more long‐term way. The requirements of the client, the orientation of the therapist or the specific agency rules are all taken into account when contracting with the client. In all of these circumstances, understanding and working with time as an explicit theme can alter the flavour of the therapy. Case studies and client vignettes will be used throughout the book to illustrate and to breathe life into what is often turgid or difficult language to understand. This edition includes new case studies and vignettes as well as those from the original book, namely, ‘Lynn’, one of the studies written by my father which was pivotal in the development of the time‐limited modular approach. In this second edition, all of the other case studies are composites and representative of being human.

      Much has changed since our writing of the first edition, including my understanding and working definition of time‐limited therapy. My own practice as a therapist, supervisor, coach, and trainer continues to inform my understanding and interpretation of existential philosophy. I am indebted to my clients, supervisees, and colleagues for the questions they ask and their inherent courage to question not only themselves but me in any of these roles and positions.

      The second edition is written to be inclusive of many of the ideas that were important to my father. I decided to use the pronoun ‘I’ rather than define which ideas and client stories were his and which were mine. This decision was part of my personal process of finding my voice and recognising my father’s influence.

      Finally, as my father had, and still has, enormous influence on who I have become and on the way I think and experience life, this second edition honours both his contribution to the world of existential practice as a therapist, coach, and mediator and the immense impact he had on defining the modular time‐limited approach. His framework still works and continues to be enormously useful.

      Note

      1 i A term used by Jean Paul Sartre (1958) to describe a form of self‐deception and avoidance of one’s freedom.

Acknowledgements

      I’m deeply grateful to my sisters Carolyn and Yvonne, to my step‐daughter Sacha Woodburn, to all my family, friends and colleagues who have supported me in my much longer than anticipated journey in completing this second edition.

      I have travelled around the world, sat at many kitchen tables with my trusted laptop and both written, revised, and conversed with my wonderful friends and family; in particular, the tables I remember СКАЧАТЬ